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Generation of Heterogeneous Drug Gradients Across Cancer Populations on a Microfluidic Evolution Accelerator for Real-Time Observation
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Published on: September 19, 2019

Dynamic precision oncology: from static mutation matching to adaptive tumor-host ecosystems

Takehiro Okabayashi1, Ryo Inada1, Motoyasu Tabuchi1

  • 1Department of Gastroenterological Surgery, Kochi Health Sciences Center, Kochi City, Kochi, Japan.

Expert Review of Anticancer Therapy
|June 10, 2026
PubMed
Abstract

Insights

Precision oncology faces challenges beyond static genomic alterations, requiring dynamic integration of tumor evolution, host biology, and systemic factors for improved cancer care. Future strategies emphasize adaptive, longitudinal, and systems-based approaches for sustained patient benefit.

Area of Science:

  • Oncology
  • Genomics
  • Systems Biology

Background:

  • Precision oncology, guided by biomarkers, has advanced cancer care but offers limited durable benefit.
  • Treatment failure is influenced by dynamic tumor evolution, host biology, and systemic pressures, not just static genomic alterations.

Purpose of the Study:

  • To review biological, technological, clinical, and systemic barriers limiting precision oncology's effectiveness.
  • To explore emerging concepts in evolutionary oncology and non-genetic resistance mechanisms.

Main Methods:

  • Narrative review of literature from PubMed, MEDLINE, and Web of Science (2015-2026).
  • Focus on therapeutic resistance, tumor microenvironment, longitudinal monitoring, biomarkers, multi-omics, adaptive trials, implementation science, and healthcare disparities.

Main Results:

  • Precision oncology is shifting towards adaptive, longitudinal, and systems-oriented management.
  • Key limitations include integrating tumor evolution, host factors, and real-time biomarker dynamics into decision-making.

Conclusions:

  • Future progress requires longitudinal molecular monitoring, adaptive therapeutic sequencing, and integrated tumor-host frameworks.
  • Equitable learning healthcare systems are crucial for advancing precision oncology.
Keywords:
Precision oncologybiomarkersctDNAimplementation scienceresistancetumor evolution

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